Deck 28: Caring for People Who Are Dying

Question 1

The nursing assistant is caring for a client recently diagnosed with congestive heart failure who is crying and states, "I was told that heart failure is not curable and the meds I fear will make me feel worse, so why take them, and I am alone and have no reason to live." What is the best way for the nursing assistant to respond?

A) Articulate that there is hospice to help the client to be comfortable till the end.
B) Report to the nurse that the client does not want to take medications.
C) Use silence and allow the client to vent feelings about the terminal illness.
D) Determine whether the client is interested in joining a senior center in their area.

Answer 1

Use silence and allow the client to vent feelings about the terminal illness.

Question 2

When a terminally ill resident starts to cry and says, "I don't want to die!," the nursing assistant responds by saying:

A) "You're in very good hands here and we'll give you with the best care possible."
B) "Dying is a natural part of living. We are all going to die someday."
C) "Please don't worry; God is waiting for you in Heaven."
D) "Would you like me to sit with you for a while?"

Answer 2

"Would you like me to sit with you for a while?"

Question 3

Which statement suggests that the terminally ill client is experiencing denial of impending death?

A) "If I could just hang on until my sister arrives from England."
B) "They're wrong; I can't possibly have an incurable brain tumor."
C) "If you medical people weren't so incompetent, I wouldn't be so sick!"
D) "I just want to spend the last few days of my life with my loved ones."

Answer 3

"They're wrong; I can't possibly have an incurable brain tumor."

Question 4

When a terminally ill resident expresses wanting the song Amazing Grace played on bagpipes at their funeral, the nursing assistant recognizes that the person is in what stage of the dying process?

A) Bargaining
B) Depression
C) Acceptance
D) Denial

Question 5

The nursing assistant is caring for a client recently diagnosed with leukemia. The client states, "although it may be grim, there is still hope that this stem cell transplant will keep me alive to walk my daughter down the aisle." What is the appropriate response for the nursing assistant to make?

A) "You seem angry at the situation."
B) "It is great to hold onto hope."
C) "You are going to be fine."
D) "Would you like to talk with clergy?"

Question 6

The nursing assistant is caring for a resident who has an "Allow Natural Death" (AND) order and has made their oldest child the durable medical power of attorney. The resident stops breathing, and the oldest child present tells the nursing assistant to perform cardiopulmonary resuscitation (CPR). What is the appropriate action for the nursing assistant to take?

A) Provide rescue breaths and check for signs of circulation.
B) Notify the registered nurse immediately.
C) Articulate that the AND is the resident's wishes.
D) Determine whether the oldest child wants clergy present.

Question 7

Which treatment would be an example of supportive care for a client with a terminal respiratory condition?

A) Providing the client with oxygen therapy to assist with breathing
B) Limiting visitors so the client can save energy for breathing
C) Putting the client on a mechanical ventilator to assist with breathing
D) Initiating cardiopulmonary resuscitation (CPR) if the client's heart stops beating

Question 8

When a terminally ill resident expresses the intention not to pursue further treatment and has decided to die, the nursing assistant responds:

A) "You mustn't give up hope! You need to try every treatment available!"
B) "I respect your decision and I will be here to help you in any way I can."
C) "How do your family and friends feel about your decision?"
D) "It's your decision but have you given it enough thought?"

Question 9

Which type(s) of health care setting can provide hospice care? Select all that apply.

A) Hospital
B) Nursing home
C) A person's home
D) Long-term care facility
E) Community senior center

Question 10

Which action is most helpful when a nursing assistant who cares for terminally ill residents begins to experience personal grief?

A) Talking with mental health professional
B) Taking personal time away from work
C) Talking to other nursing assistants about the feelings
D) Transferring to a unit that doesn't deal with terminally ill clients

Question 11

A dying client has begun to perspire heavily, and the skin feels cool and clammy. These observations indicate that the client's:

A) room is too cold.
B) circulatory system is failing.
C) nervous system is failing.
D) diet needs to be changed.

Question 12

A nursing assistant who is very uncomfortable with the idea of death and dying is at risk for:

A) not being able to provide dying clients with the care needed.
B) crying the first time a client dies.
C) becoming depressed when growing older.
D) losing the job as a nursing assistant.

Question 13

The rights of a dying person include:

A) a private room.
B) peaceful, dignified death.
C) being uncooperative with treatments.
D) being cared for by those of the same religion.

Question 14

Which task(s) would be a part of meeting a dying person's physical needs? Select all that apply.

A) Taking measures to make communication easier
B) Gently cleaning the eyes with a warm, wet washcloth
C) Being aware of any changes in the person's care plan
D) Being sure the person is eating all the food on the meal trays
E) Checking the person regularly for incontinence of urine and feces

Question 15

When caring for a dying person, a nursing assistant will do all of the following, except:

A) keep the room well-lit to help the person to see well.
B) introduce oneself when entering the person's room.
C) encourage the family members to talk to the person.
D) discuss potentially upsetting topics in front of the person.

Question 16

A nursing assistant can help meet a dying person's emotional needs by:

A) entertaining the person with amusing stories.
B) encouraging the person to attempt light exercise.
C) being a good listener when the person needs to talk.
D) insisting that the person needs to share feelings.

Question 17

When a dying client wants to talk about a belief in reincarnation, the nursing assistant:

A) asks why the client believes reincarnation is possible.
B) listens to the client sharing these beliefs.
C) shares personal beliefs about reincarnation.
D) offers to call the chaplain for a visit.

Question 18

The nursing assistant best supports the family of a dying client by:

A) providing the family with blankets and pillows if they are staying the night.
B) allowing the family unlimited visiting hours and access to their loved one.
C) ensuring that the dying person's basic needs are met promptly and effectively.
D) informing the facility chaplain that the client is dying, and the family is there.

Question 19

The nursing assistant enters the room of a resident who has a do not resuscitate (DNR) order and observes that the resident is lying motionless and is not breathing. What is the priority action for the nursing assistant to take?

A) Activate the emergency call system.
B) Document the observations.
C) Establish the time the client was discovered.
D) Notify the RN of the observations immediately.

Question 20

The RN delegates postmortem care to the nursing assistant for a resident who died an hour ago. The nursing assistant has at least 1 hour of high-priority tasks that must be performed for other residents. What action should the nursing assistant take?

A) Choose another nursing assistant to ask to do the postmortem care.
B) Determine that the postmortem care can wait until the tasks are caught up.
C) Prepare the resident's body following the procedure for postmortem care.
D) Explain to the RN that there is 1 hour's worth of assigned tasks that must be done.

Question 21

If the nursing assistant is the only member of the staff present when a client dies, the nursing assistant will be required to:

A) legally pronounce the person dead.
B) cover the body with a sheet or bath blanket.
C) try to revive the person using first aid techniques.
D) notify the nurse and take note of the time of death.

Question 22

What is the role of nursing assistant when providing postmortem care?

A) Removing any prosthetic devices so they can be given to the family
B) Washing the body and dressing it in a clean gown
C) Notifying the family that the person has died
D) Applying makeup to the face of a female client

Question 23

The nursing assistant helps the nurse with postmortem care for two separate clients who died on the hospital unit. What action indicates that the nursing assistant requires further instruction? When the nursing assistant:

A) applies a different name on toe tag than on the client's ID band.
B) helps turn the client to place the shroud on the client.
C) leaves the client's dentures in but places a rolled cloth under the chin.
D) collects the personal belongings and places them in a bag with the client's ID.

Question 24

A nursing assistant finds that providing postmortem care for deceased residents is very emotional and is becoming very difficult to do effectively. The nursing assistant will first:

A) respectfully refuse to perform postmortem care.
B) talk about the situation with the nursing supervisor.
C) keep remembering that postmortem care is a part of the job.
D) ask to be allowed to have another nursing assistant perform that task.

Question 25

When providing postmortem care, the nursing assistant will always:

A) ask the family members to wait outside the room.
B) have help from another nursing assistant or nurse.
C) follow standard precautions when handling the body.
D) be professional and not show emotions to the deceased's family.

Question 26

The nursing assistant is caring for a client in the terminal stages of cancer. In order to best meet the needs of the family, the nursing assistant would say:

A) "Would you like to step out while I turn and reposition your mother?"
B) "It's time to turn and reposition your mother; would you like to help?"
C) "I'll be repositioning your mother in 10 minutes in case you want to help."
D) "I know you want to help care for your mother; I'll let you know what you can do."

Question 27

The nursing assistant is caring for a resident who recently experienced a stroke and is now comatose. Which action best shows that the nursing assistant understands the special needs of a comatose person?

A) Sharing that, "Your grandson called and wanted you to know he'll visit on Sunday."
B) Dressing the resident in a favorite outfit and combing the resident's hair in the preferred style.
C) Making sure that there are fresh flowers in the room since the resident always liked that.
D) Telling the resident that, "Things will get better; just wait and see."